Hearing complaints among veterans following traumatic brain injury.
Frederick J Gallun, Melissa A Papesh, M Samantha Lewis
PMID 28981349WHAT IT FOUND
Veterans with blast or mild head injury often report trouble understanding speech in noise, on the phone, or with long or rapid speech despite normal hearing thresholds.
Clinicians should assess auditory processing, not rely on pure-tone audiograms alone.
Key findings
01In a sample of Veterans with previous blast exposure and normal or near-normal pure-tone hearing thresholds, 60% reported moderate to severe hearing handicap affecting daily life.
02Common complaints after head injury include difficulty understanding speech in background noise, rapidly spoken or long-running speech, and telephone conversations.
03Patients with previous head injury who report auditory difficulties should be evaluated for possible auditory processing disorders, even when the injury occurred years earlier.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The article is a narrative review, not a systematic review, so it does not report a search strategy, selection criteria, or quality appraisal. It reports no original participants, randomisation, blinding, or outcome testing. The review notes no clear epidemiological evidence on the prevalence of auditory dysfunction after mild TBI. Imaging methods that might link auditory deficits to specific brain injury are not yet common clinical tools. Most electrophysiology studies reviewed focus on civilian populations, so blast-exposed military patients may be underrepresented. Baseline auditory function before injury is often unavailable, so abnormal performance cannot always be attributed to injury. The review does not provide evidence that hearing aids, FM systems, or auditory training improve outcomes.
The easy way to misread this
Do not conclude that normal pure-tone hearing means there is no auditory problem after TBI. The review reports patients with normal or near-normal thresholds who still have hearing handicap and central auditory processing complaints.